In case of a planned hospitalization, client needs to inform Health Assist two to three days in advance by faxing us the pre-authorization form (form on Website) signed by the treating doctor. Your claim would be assessed in the light of the policy issued to you by your insurance company and a letter of authorization will be issued to the hospital authorizing the patient's treatment. In case of an emergency the hospital will fax the pre-authorization letter. Once the Authority letter is sent to the hospital from Health Assist, you need not pay to the hospital. Health Assist will pay your hospital bills up to the amount authorized in the Authority letter.

You are required to intimate the TPA or your insurer within 24 hours of hospitalization.

In general you are required to submit your reimbursement claims within 10 days from the date of discharge. (However it varies from insurer to insurer).

You can lodge your claims at our office or the respective branch of insurance company. Please call us on 18001025671 / 011-45451300 or write us @ info@safewaytpa.in for claim intimation

For any changes in mediclaim policy

• You must directly contact the insurance company
• The insurance company will forward the endorsement letter for changes to Health Assist
• Then we will update our record as per endorsement wordings.

If there is any mistake in TPA card only like : Name, Gender, Age, Photo etc, you can send an e-mail cards@safewaytpa.in for correction and also you can call us on 18001025671, informing the customer care department to make the requisite changes.

If there is any mistake in policy like name/age/gender/address etc, you need to contact the insurance company, they will forward us the endorsement letter for the necessary correction. After receiving the endorsement letter from the insurance company, Health Assist will make corrections in the requisite field.

Certain diseases that are not covered under the policy as mentioned in the exclusion clauses are called exclusions.

As per the exclusion clause 4.2 of the policy any disease contracted by the insured person within the first thirty days from the commencement date of policy is not payable unless proved by the panel of doctors that the insured could not have known of the disease before the commencement of the policy.

Charges for diagnostic test consistent with or incidental to the diagnosis and treatment of the positive existence or presence of any ailment, sickness or injury are payable.

You can claim medical expenses incurred 15 days to 30 days before and 60 days to 90 days (as specified in your policy), provided they are related to the ailment/accident for which you were hospitalized. Such expenses are termed as pre and post hospitalization expenses.

Typically there is a waiting period of 30 days, within which no claims by the insured are entertained by the insurer. This waiting period may vary from one insurance company to insurance company. We strongly recommend you to read your policy document carefully or call us with your policy details

You need to follow the below mentioned process.

• Dully Filled claim Form
• Original Discharge Summary
• Original Final Hospital Bill
• The complete breakup of the final hospital bill (breakup of medicines given, laboratory tests) in original
• Original receipts of payment in lieu of the final hospital bil
• All original investigation reports (e.g. blood test reports, X ray films and reports, MRI films and report) in original ---whichever applicable.
• All the bills/receipts for which claimant is claiming in original
• All the prescriptions, medicine bills and the investigations report in original
• All past policy copies if any

Documents should be submitted to Health Assist, within 10 days of discharge from the hospital. All the above documents have to be submitted in original

Typically, the insured can make a claim if his/her hospitalization is more than 24 hours. However, for certain treatments, such as dialysis, chemotherapy, eye surgery, etc, the stay could be less than 24 hours.

Please visit www.safewaytpa.in, click on network provider if you are a corporate policy holder. For individual policy holders you have to click on Hospital Network & Follow the steps.

Before taking mediclaim policy if there are any existing diseases before taking the policy, these diseases are classified as pre-existing diseases.

The non-mediclaim expenses are mentioned as below:

• Admission charges
• Extra bed charges for attendant
• Telephone expenses
• Food and beverage charges for attendant
• Vaccination & Dietician charges etc.
• Cotton & some internal injection and bandage charges etc.
• Some other charges not payable under the mediclaim policy terms & conditions you must see your policy details for the same

In a standard mediclaim policy certain diseases are not payable in the first year of insurance cover. These diseases are payable after a 12 month of continuous cover, if they were not contracted before the commencement of the policy. These diseases are Cataract, Benign Prostatic hypertrophy, Hysterectomy for menorrhegia or fibromioma, hernia, hydrocele, congenital internal diseases, fishula in anus, piles, sinusitis and related disorders.

No, dental treatment of any kind is not covered unless requiring hospitalization